BackCare

Sex and back pain

2009 Author: Susan Quilliam and Joy Haughton

All the above can be significant problems for back pain sufferers. But sex? Surely that’s the last of your worries if your back has flared up – and the last thing you'll feel up to if even small movements are a strain?

But think again. Research has constantly shown that a healthy sex life, either as part of a couple or solo through masturbation, has significant emotional and physical benefits. Sex can relax, comfort and calm – all things that are much needed when back pain is putting you under stress. This article will show you, step-bystep, just how to approach sexuality so that your back is not put under strain – and your love life isn't compromised.

Start by talking

The very first step is to talk. Set aside some quiet time outside the bedroom, to get your feelings and worries out in the open and start to create a solution.

If you’re the partner in pain, then explain in detail what hurts and when. Be specific about which movements are problems for you. It will help your partner to be sympathetic and supportive if they know as much as possible about what your body can and can’t do.

 But don't just stop at the physical. Difficult though it can be, talk emotions too – tell your partner how you're feeling at the moment, what worries you about your condition and its effect on your relationship.

But equally important is an opportunity for the partner without pain to speak. Often when one partner is ill all the focus will be on them. But the ‘well’ partner will also be under strain; they need a chance to talk too. That in itself will bring you closer, make sex more rewarding, get you thinking about solutions.

Get comfortable

And so, on to the practicalities. You need to work out how to make yourself as comfortable as possible before sex. If there are particular things you’ve discovered that help you reduce your pain, then use them.

You may find medications, ice packs, heat packs, baths, gentle exercise or breathing exercises worth trying. Not all of these will work for you, so it is worth talking to a health professional about which are most likely to help your condition and then experiment. Once you’ve discovered your recipe, then use it to get yourself in the best state possible before heading to the bedroom.

Although, in fact, it may not be the bedroom you head for! Some people with back problems find that bed is one of the least relaxing surfaces for them. A hard floor may be better for you, or perhaps a chair or a large cushion. Again, feel free to experiment; keep listening to your body.

Get support

Once you’ve found the best spot in the house, make sure you have available some further supports to help you get into low-pain positions – rolled towels, small cushions or pillows and even some hot or cold packs. And don’t forget, anywhere can be made a bit more romantic with the addition of a few candles, some soft music and a delicious scent.

It will also help to agree a ‘safe word’ with your partner that will allow either of you to stop the proceedings if you’re in pain or have any concerns. This can be anything, but it’s best to use something that wouldn’t normally come up in pillow talk, such as ‘carrots’ or ‘potatoes’!

Also, if you're worried that your energy or tolerance levels won’t survive a long session of love-making, then set a time limit – maybe as little as five minutes for the first day – you can always agree to ignore the limit if things are going well, or keep increasing it day by day as your confidence grows. It will also help to make love at the time of day that is least painful for you.

Find good positions

Now that everything is ready, find the most comfortable position for you. You may want to try lying on your back, front or side or even staying seated in a chair. On your back, try popping a pillow under your knees to keep them slightly bent; a rolled towel under the small of your back may also be helpful. If lying on your side feels fairly good, then a folded pillow or towel between your knees will take the strain off your lower back.

On your front, a pillow under your tummy or chest may well be helpful – however, if you also have neck problems, lying on your front may be one to avoid as it is likely to be aggravating. Staying seated (either in a chair or propped up on cushions on the floor) can be a great option if you find lying down increases your pain. Again, use rolled towels to support the small of your back and pillows under the knees if required.

Make connection

So, that’s the position sorted – now you can finally start getting down to business! It’s very likely that you won’t want to dive straight into intercourse, particularly if you haven’t had much sex for a while due to your pain levels. This is a great opportunity to get creative about what you include in sex and really stimulate all your senses – thus distracting yourself from any niggly pains in your back.

So, do give yourself lots of time for stroking, kissing, caressing. Talk dirty or tell each other fantasies. Use sex toys to create new sensations. Basically, your imagination is your limit, so stretch it!

Use hand and mouth

Don’t leave out oral sex and hand stimulation. These are fantastic techniques to perfect, as they can allow you to stay fairly static, if needed, while your partner does the work. Equally, if you are the one without pain, you should be able to position yourself fairly easily so your partner can pleasure you with hand or mouth, without needing to get their back into tricky positions.

For example, try standing in front of a seated partner or lying head to toe – really anything that lines up the right bits with the right bits! If the positioning is a bit of a challenge, or if you're having a solo session, you can stimulate yourself – maybe while your partner provides strokes or whispered instructions.

And... penetrate

Last, but by no means least, once you’re in a comfortable position, you can move into intercourse. Any of the positions described above will work, but depending on your particular pain you may find some work better than others.

Women with back pain will probably find side to side penetration the most gentle. If it is the male partner in pain he may find it most comfortable to avoid thrusting too vigorously, perhaps by letting his female partner go on top. Conversely, if it is the female partner in pain, she may let him go on top.

If you are the partner without pain, then encourage your lover to give you feedback on what hurts and what doesn’t – start gently with any technique and build up slowly. Both partners should be sure to make lots of positive noises if something is working well for you. It’ll help to build confidence in both of you and make sure the mood stays sexy.

However, if something does hurt, or if you're concerned you’re hurting your partner, just use your safe word – it’s better to stop for a brief pause than to put yourself out of action for days by over-reaching your limits.

Take your climax

One final note on the subject of orgasms. Some back pain sufferers find that these will relax them and so reduce pain levels – if this is you, then great; go for it!

However, some people find that the muscle tensions associated with orgasm can actually flare pain up slightly. If this is the case for you or your partner, don’t panic. A great sex life is still very possible without orgasms, or without a lot of orgasms. I

nstead, focus on stimulating the senses, fostering an emotional closeness and providing pleasure. With time, you may find different, more relaxed climaxes are possible, but either way you will be getting all the relationship and emotional benefits of sex.

Be hopeful

This article has given you an insight into how you can adapt your lovemaking techniques to suit the needs of you both. However, if you are still struggling then do get further help sooner rather than later. Some sessions with a sex or relationship therapist may be all that is needed to get things sorted – Relate or your GP will be able to help. A

bove all, be hopeful. Back pain doesn’t have to mean an end to your love life. With a little forethought and experimentation, there can be sex after back pain!

Susan Quilliam, a sex and relationship psychologist, is the author of the recently published reinvention of the famous book, The Joy of Sex, and agony aunt for That’s Life magazine and LBC radio. Joy Haughton has a degree in psychology and has worked with Susan for over three years, whilst training part-time as an osteopath.